Surgical appliance



1948- H. G. HITTENBERGER 2,434,883

SURGICAL APPLIANCE Filed June 2, 1944 INVENTOR. HERMAN. G. HITTENBERGER f Q ATTORNEY Patented Jan. 20, 1948 UNITED STATES PATENT OFFICE 2,434,883 SURGICAL APPLIANCE Herman G. Hittenberger, Alameda, Calif.

Application June 2, 1944, Serial No. 538,465

6 Claims. (Cl. 128-95) My invention relates to a surgical appliance, and more particularly to a brace for immobilizing the pelvic and lower lumbar region of the spine.

Among the objects of my invention are:

1. To provide a novel and improved brace for effecting greater support and immobility to the lumbar spine, sacroiliac joint and pelvis;

2. To provide a novel and improved brace offering greater freedom of movement to the patient without binding;

3. To provide a novel and improved brace offering wide range of adjustment to the wearer;

4. To provide a. novel and improved brace which in the course of use encourages correct posture on the part of the wearer;

5. To provide a novel and improved brace of relatively light-weight, and designed to direct pressure at the locations and in the directions desired;

I 6. To provide a novel and improved brace which effectively holds the pelvic bones against the sacrum;

'7. To provide a novel and improved brace capable of being tightened, obtaining an essential posterior construction by the wearer with little effect on his part and to a greater degree than provided for in prior art braces with which I am familiar.

Additional objects of my invention will be brought out in the following description of a preferred embodiment of the same, taken in conjunction with the accompanying drawings where- Figure 1 i a three-dimensional view of a preferred embodiment of my invention;

Figure 2 includes an elevational and sectional view illustrating the construction of the posterior pad constituting a portion of my improved embodiment.

Figure 3 includes an elevational and sectional View illustrating the construction of the anterior pad forming an element of my preferred embodiment.

With reference to the drawings for a more complete and detailed description of the preferred embodiment of my invention, the brace contemplates the use of a posterior pad I and an anterior pad 3 of such construction enabling them to be operatively interconnected for obtaining desired pressure characteristics.

The posterior pad adapted for positioning against the lower lumbar region of the spine, includes a framework involving a pair of vertically disposed stiff resilient strips 5, l pivotally connected by rivets 9 to the ends of a cross- 2 member H at points below the midpoint of the vertical strips 5, 1 and preferably about two-thirds down from the top thereof, to provide fulcrum points for such strips,

A lower transverse strip l3 of flexible material is provided with a pair of arcuate slots I5 symmetrically disposed with respect to the midpoint of the transverse strip. Each of said slots serves to slidably receive a shoulder rivet ll aflixed at the lower end of each of the vertical strips.

An upper transverse strip !9 is similarly provided with corresponding arcuate slots 2|, each to slidably receive a shoulder rivet 22 applied to the upper end of each of the vertical strips.

The upper slots 2|, however, will be somewhat greater in length than those in the lower transverse strip !3 in accordance with the extent of swing of the upper ends of the vertical strips as compared to the extent of swing of the lower ends of such strips, when the strips are rotated on their respective fulcrum rivets 9. Y

The anterior pad 3 adapted for positioning against the abdomen when the brace is applied to the wearer, is formed of a thick base layer 23 of felt and an outside layer 25 of leather or other suitable material. This pad is reinforced by a pair of spaced reinforcing strips 21, 29 preferably of metal, which are perforated for attachment thereto of a plurality of studs 3!. These studs are applied through the outer layer of leather and serve to position the reinforcing strips prior to stitching such outer layer to the base layer of felt. I

The aforementioned .posterior and anterior pads are interconnectable by a plurality of pairs of straps including pelvic straps 33, intermediate straps 35, and final-pressure adjusting straps 31.

The pelvic straps are each connected at one end to one of the shoulder rivets H at the lower end of each of the vertical strips 5, 1, and at its free end is provided with buttonholes 39 for adjustable connection to a stud on the anterior pad.

The intermediate straps are each connected at one end to one of the fulcrum rivets9 and, like the pelvic straps, has its free end provided with buttonholes for connection to another of the studs on the anterior pad.

The final-pressure adjusting straps each has one end connected to one of the shoulder rivets 22 at the upper end of each of the vertical strips and, like the previously referred to straps, has its free end provided with buttonholes for adjustable connection to another of the studs on the anterior pad.

As thus far described, the apparatus is capable of demonstrating an important feature of my invention, namely the manner in which a high degree of immobilizing pressure may be developed in the application of the brace to the body. In realizing this function, the posterior pad I is held against the lower lumbar region of the spine while the intermediate and pelvic straps 33 and 35 are adjustably secured to the anterior pad through: selection oithe proper-buttonholes which will assure a fair degree of tightness of these straps. In so adjusting the pelvic straps, the lower ends of the vertical strips will be separated to the maximum distance permitted by the arcuate slots l5.

At this stage in the application? of the brace, the final-pressure tightening straps 31 are grasped by the wearer and pulled in opposite die. rections to draw the upper ends of the. vertical strips apart- The resulting spreading of the upper ends of these strips will result in a corresponding drawing together; of the lower ends, thereby greatly increasing the tension and the corresponding tightening effect upon the pelvic straps. When the desired added tension has been applied to the pelvic straps, the final-pressure tightening straps are then drawn around to the front of the wearer and connected to studs on the anterior pad, 3, whereby thefina-I tension developed in, the pelvic straps will be maintained.

By positioning the fulcrum rivets 9 below the midpoints of the vertical strips, a mechanical advantage is realized, whereby a high degree of tension may be developed in the pelvic straps without unreasonable degree of tension being applied to the final-pressure tightening straps by the wearer in adjusting the. brace to its final-pressure condition.

A pad 4| slidably mounted on each of the pelvic straps 33, is adapted to be positioned at such point where pressure will also be applied to the pelvic bones, such pads further serving to re lieve the body from pressure along uncovered portlons of the Pelvic straps and thus concentrating the. pressure against the pelvic bones. Thus, these pads, in cooperation with the posterior pad, function as a vise to, immobilize the entire pelvic 185 9 Ijhe framework involving the vertical strips 5,, I; and associated member constitutes the skeletonfq j 17 1.6 Posterior pad I which is finished off by a heavy base layer 43 of felt on the body side, to which the skeleton is riveted, and an outside layer 45.. t leather or other suitable material sewed, to the, felt base, leaving suitable edge openings for t e str ps.

'Ijhe members. of this framework provide the necessary idity deman d o the post r p when, applied under pressure against the lower lumbar region of the spine, in this connection, the spacedw vertical strips 5, l are preferably of semi-rigid bendable material such as Duralumin 0,1 beryllium copper alloys, whereby they may be adjusted as to the curvature of a patients body and in accordance with the amount of correctipndesired in a particu ar ase.

These strips are furthermore preferably tanered toward. t e r pper en s o adu l y crease. the flexibility thereof from a condition of substantial rigidity at the lower ends, such taper serving to obviate the undesirable tendency toward muscular atrophy which is encountered; in other race cons ruc o s Maintenance of the brace in its properly adeiust d p si ion on the qdm. i su by the provision of a pair of perineal straps 41; One

end of each of such straps is provided with a buttonhole for attachment to a stud at the lower edge of the anterior pad, while the other end of each of such straps is adjustably secured in a buckle 49 suspended from each of the pads 41 carried by the pelvic straps 33.

My improved brace is applicable for use in connection with any injury to the lumbar spine or pelvis Where it. becomes. necessary in. effecting a cure, to. immobilize the. entire region thereabout, and more specifically may be employed in connection with the treatment of extrusion of the intervertebral disks, spondylolisthesis, fracture of thepelvis, and sacroiliac strain.

While, I have disclosed my invention in a preferred form and have described the preferred embodiment in considerable detail, it is apparent that, the same may be modified or altered without departing from the, basic principles thereof, and I accordingly do not desire to be limited in my protection to such details, except as may be necessitated by the appended claims.

I claim:

1. A brace comprising a posterior pad including a pair of spaced vertically disposed strips, means pivotally connecting. said strips at a level below the mid points thereof to provide a fulcrum for each of said strips, whereby to permit an approach of the lower ends of said strips toward each other in response to a separation of the upper ends, means secured to the lower ends of said strips and capable of being fastened about the body of a patient, and final-pressure adjusting strap means secured to the upper ends of said strips and; also capable of being fastened about the body of; such patient.

2-. A brace comprising a posterior pad, an anterior pad, one of saidpads including a pair of spaced vertically disposed strips, means pivotally connecting said strips at a level below the midpoints thereof to provide a fulcrum for each of said strips, whereby to permit an approach of the lower ends of said strips toward each other in response to a separation of the upper ends, each secured to the lower end of one of said strips and connectable at its other end to the other pad, and a pair of final-pressure adjusting straps each pivotally secured to the upper end of one of said strips and also connectable to said other pad.

3. A brace comprising a posterior pad, an anterior pad, said posterior pad including a pair of spaced vertically disposed relatively stiff strips, a cross-member substantially horizontal pivots connecting said cross-member to said strips at points below the midpoints thereof to provide fulcrum points for said strips, whereby to permit an approach of the lower ends of said strips toward each other in response to a separation of the upper ends, a pair of pelvic straps, each secured to the lower end of one of said strips andconnectable at its other end to said anterior pad, and a pair of final-pressure adjusting straps each secured to the upper end of one of said strips and alsoconnectable to said anterior pad.

4. A brace, comprising a posterior pad, an anterior pad, said posterior pad including a pair of spaced Vertically disposed relatively stiff upwardly tapering strips, a cross-member pivotally connected to said strips at points below the midpoints thereof to provide fulcrum points for said strips, whereby to permit an approach of the lower ends of said strips toward each other in response to a separation of the upper ends, a pair of pelvic straps, each secured to the lower end of one of said strips and connectable at its other end to said anterior pad, and a pair of final-pressure adjusting straps each secured to the upper end of one of said strips and also connectable to said anterior pad.

5. A brace comprising a posterior pad, an anterior pad, said posterior pad including a pair of spaced vertically disposed relatively stiff strips, a cross-member pivotally connected to said strips at points below the midpoints thereof to provide fulcrum points for said strips, whereby to permit an approach of the lower ends of said strips toward each other in response to a separation of the upper ends, a pair of pelvic straps, each secured to the lower end of one of said strips and connectable at its other end to said anterior pad, a pair of final-pressure adjusting straps each secured to the upper end of one of said strips and also connectable to said anterior pad, position-adjustable pads slidably mounted on said pelvic straps, each of said position-adjustable pads carrying a buckle, and a pair of perineal straps, each connectable at one end to said anterior pad and adjustably passing through one of said buckles.

6. A brace comprising a posterior pad including vertically disposed lever means, pelvic strap means secured to said lever means and capable of being fastened about the body of a patient, and final-pressure adjusting strap means secured to said lever means for efiecting a tensioning of said pelvic strap means and capable of being fastened about the body of such patient to maintain such tension.

HERMAN G. HITTENBERGER.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 633,596 Kellogg Sept. 26, 1899 746,872 McElfresh Dec. 15, 1903 1,188,709 Wenzel June 27, 1916 1,402,448 Saur Jan. 3, 1922 1,935,859 Putz Nov. 21, 1933 1,974,283 Kendrick Sept. 18, 1934 2,036,484 Le May Apr. 7, 1936 FOREIGN PATENTS Number Country Date 202,201 Great Britain Aug. 16, 1923 538,274 France Mar. 16, 1922 50,097 Austria Apr. 15, 1911 OTHER REFERENCES Griswold, R. A., A Three-Point Hyperextension Back Brace, Journal of Bone & Joint Surgery, July 1936, pages 784-786. 

